1. Field of the Invention
The present invention is directed to a picture archiving and communication system which includes improved image routing, retrieval and display capabilities, among other things. The invention has particular utility in a hospital, or group of hospitals, since it facilitates inter-departmental access to patient images produced by different types of imaging modalities.
2. Description of the Related Art
Modern hospitals, like any other business, make use of digital computers and networking technology to manage different types of data. Much of this data, such as admissions information and the like, can be handled without the use of specialized hardware and software. On the other hand, certain types of clinical data, in particular medical images, cannot be managed in the conventional manner. Rather, specialized hardware and software is required to route, retrieve and view this data. This specialized hardware and software is known in the art as a picture archiving and communication system (or xe2x80x9cPACSxe2x80x9d).
In general, a PACS includes one or more imaging modalities, an archive, and plural reviewing stations. The imaging modalities take images of a patient using technologies such as X-ray, computed tomography (xe2x80x9cCTxe2x80x9d), magnetic resonance imaging (xe2x80x9cMRIxe2x80x9d), nuclear medicine (xe2x80x9cNMxe2x80x9d), and ultrasound (xe2x80x9cUSxe2x80x9d), to name a few. The images are then stored in the archive, from which they may be subsequently retrieved and viewed on a reviewing station. The imaging modalities, the archive, and reviewing stations are typically integrated either via a local area network (xe2x80x9cLANxe2x80x9d) or a wide area network (xe2x80x9cWANxe2x80x9d).
Conventional PACS suffer from several drawbacks, particularly in the areas of routing, retrieving and displaying images. With respect to image routing, in conventional PACS, an imaging modality takes an image of a patient and then the image is routed to an archive, where it is stored. Thereafter, a user at a reviewing station must retrieve the image from the archive in order to view the image. This system is inefficient for a number of reasons. For example, it requires the user to retrieve images manually, and thereby expend extra time and effort to complete the review process. In this regard, when the PACS network is busy, different users often compete for system resources, resulting in a slow system response and thereby further increasing the time required to complete the review process.
With respect to image retrieval, as noted above, conventional PACS require a user to retrieve an image from a central archive. This can be inefficient, especially if a copy of the image is located in an area of the PACS which is more easily accessible to the user than the archive. Moreover, when dealing with xe2x80x9cstudiesxe2x80x9d (i.e., one or more images of, e.g., a body part of a patient), conventional PACS retrieve an entire study before any images therefrom are actually displayed to the user. Again, this is inefficient, since it prolongs the reviewing process.
With respect to displaying images, conventional PACS typically provide a fixed set of controls by which a user may sort, select and display certain studies and/or images. While these controls may be sufficient in some circumstances, oftentimes users will find them inadequate to meet their particular needs. On the other hand, this fixed set of controls may also be more than the user desires and/or may have characteristics, such as an undesirable screen location or the like, that the user finds inconvenient.
Accordingly, there exists a need for a PACS which addresses the foregoing and other drawbacks of conventional PACS. In particular, there exists a need for a PACS with improved routing, retrieval and display capabilities which enhance the overall efficiency of the system, and which make the system more user-friendly.
The present invention addresses the foregoing needs. In particular, the present invention is a PACS with routing, retrieval and display capabilities that surpass those of its conventional counterparts, and with additional enhancements and features that make the subject PACS both efficient and user-friendly.
Generally speaking, the PACS of the present invention includes core components arranged in a cluster. These core components include an archive station which has access to a long-term memory for storing image data, and a reviewing station which has a display for displaying images based on received image data. Also included in the core components is a network gateway, which interfaces to a non-core component so as to receive image data therefrom, and which routes the image data to at least one of the archive station and the reviewing station based on a set of routing rules in the network gateway. Finally, a database server manages access to the image data, and stores information relating to the image data.
According to one aspect, the PACS includes a plurality of reviewing stations, each which is designated to receive images based on predetermined routing rules. In this aspect, the network gateway receives the images from an external source, determines, which if any, of the reviewing stations that each image should be routed to based on the predetermined routing rules, and routes images to appropriate reviewing stations. By routing the images to appropriate stations, rather than blindly routing all images to a central archive (as is done in conventional PACS), the present invention reduces the amount of time it takes for users to access and view the images.
In preferred embodiments, the invention determines the routing rules based on one or more of the following: a set destination, a radiology specialty, image status, a referring physician, patient location, time, image category, and imaging modality. Moreover, the invention provides a way for the user to set the routing rules by selecting one or more of the foregoing options, thereby enabling the user to generate customized routing tailored to specific needs. In particularly preferred embodiments, the user selects the above options using one or more forms which are accessible via hyperlinks. This feature, in particular, makes the PACS easy to use.
In other preferred embodiments, the network gateway is able to determine if received images and their corresponding information comport with what is already stored in the PACS. Specifically, the network gateway determines if any received images include additional information that is inconsistent with corresponding information on the PACS, and corrects the additional information in any such received images prior to routing the images. Thus, the network gateway both prevents flawed (i.e., xe2x80x9cbrokenxe2x80x9d) images from entering the PACS and/or from corrupting currently-existing PACS data. This feature is particularly advantageous in the medical field, where data accuracy can literally mean the difference between life and death.
In still other preferred embodiments, the network gateway is able to route images to a plurality of other (e.g., non-reviewing) stations in accordance with predetermined routing rules. Examples of these other stations include the archive station and PACS extensions (i.e., non-core components), most notably a referring physician station which displays images received from the network gateway and a clinical station which also displays such images. Similarly, the network gateway may also route images to peripherals, such as a Web server which sends the images out over the Internet and a printer which prints the images.
According to another aspect, the PACS pre-fetches images (and/or summaries of information relating to the images) in response to a scheduled event. In this regard, xe2x80x9cpre-fetchingxe2x80x9d refers to the process of automatically (i.e., without user intervention) retrieving images (and/or summaries) before the scheduled event. In this aspect, the PACS includes at least one station capable of displaying the images, and a network gateway which communicates with the station and a remote source (e.g., a hospital radiology information system, or xe2x80x9cRISxe2x80x9d). The network gateway receives information concerning the scheduled event from the remote source, queries the remote source for details on the scheduled event, receives the details from the remote source, and retrieves images (and/or summaries) from a memory on the PACS based on the details and one or more predetermined pre-fetching rules. By effecting pre-fetching in this manner, the invention further reduces the amount of time required to review images. That is, because the images and/or summaries have been pre-fetched, they will be ready and waiting for the reviewer (e.g., a physician) at the time of the exam. With regard to the summaries, retrieval of the summaries only is a significant advantage, since it eliminates the need to retrieve an image when only its summary is needed.
In some embodiments of the invention, e.g., in a case that the station noted above has its own internal cache, the network gateway may route the retrieved images directly to the station. In other embodiments, however, most notably the case where the station is cache-less, the network gateway stores the retrieved images in memory (e.g., a cache on an archive station), and waits for a request from the reviewing station before routing the retrieved images thereto. By providing this flexibility, the PACS can be implemented using either xe2x80x9ccachedxe2x80x9d or cache-less reviewing stations, depending upon the PACS users"" available hardware, preferences and/or needs.
According to another aspect, the invention is a workstation (e.g., a PACS core component or a PACS extension) which effects pipeline image retrieval in accordance with the present invention. The workstation does this by retrieving images from one or more caches located in different components of the PACS, rather than always retrieving the images from a central archive as is done in conventional systems. The workstation includes a display screen capable of displaying images and one or more memories which store computer-executable process steps and a list of studies, each of which is comprised of one or more images. A processor in the workstation executes the process steps in order to retrieve image data for designated studies in the study list and to form images on the display screen using the image data. These process steps include code to select caches of one or more different PACS components, to retrieve image data for designated studies from caches of the selected components, to form each image in the studies from retrieved image data, and to display each image on the display screen once the image is formed, without waiting for image data for any additional image data to arrive.
The foregoing aspect of the invention takes advantage of the fact that images in PACS component caches may be more accessible than those on the archive may be. Thus, by permitting retrieval of image data from caches, rather than requiring that image data be retrieved from the archive (as is the case in the invention""s conventional counterparts), the invention reduces image retrieval time, and thus increases the system""s efficiency. Moreover, the invention saves additional time by displaying individual images of image data, rather than waiting until image data for a full study has been received.
In preferred embodiments, the caches of the different PACS components are selected based on a user input. For example, the workstation may display a user interface which includes a list of studies, at least one of which has a xe2x80x9ccachedxe2x80x9d status designation associated therewith. The user input in this case comprises simply selecting at least one of the studies in the list which has the xe2x80x9ccachedxe2x80x9d status designation associated therewith, whereafter the workstation identifies the cache by correlating it with the selected study. Of course, selection can also be made automatic, e.g., by including code in the workstation to seek out all studies in the list with a xe2x80x9ccachedxe2x80x9d status designation, and then selecting caches associated with those studies.
According to still another aspect, the PACS includes a workstation which generates a user-customized PACS display (e.g., a main study list, worklist, display toolbar, etc.). The workstation includes a memory and a processor which executes stored process steps in order to invoke display of at least one form (e.g., a user profile form) which includes settable options for altering the PACS display, to store user inputs to the form which correspond to the settable options, and to generate the user-customized PACS display based, at least in part, on the user inputs to the form. Thus, with respect to the PACS display, the invention is more flexible, and thus more user-friendly, than its conventional counterparts.
In some embodiments of the invention, the PACS display comprises a list of studies (e.g., a main study list), each of which includes one or more images, and a plurality of action buttons. In these embodiments, the above form includes options to select which action buttons appear on the PACS display. An additional form (e.g., an access control form) may also be invoked to provide the user with the ability to customize the PACS display even further.
In other embodiments, the PACS display comprises a toolbar that is displayed concurrently with medical images. The toolbar includes a plurality of action buttons which affect image display. In these embodiments, the form includes options affecting where on the display screen the tool bar is displayed and a format of the toolbar, in addition to options for selecting which action buttons will be displayed in the toolbar.
In particularly preferred embodiments, the PACS display (e.g., the toolbar) includes action buttons for manipulating displayed images. Among the action buttons which may be included on the toolbar are an action button to collimate displayed images, an action button to affect the orientation of displayed images, an action button for re-ordering displayed images, action buttons for dynamically displaying images, action buttons particularly for use with CT images, and action buttons for adding information to displayed images. These features (and others listed below) provide PACS users with enhanced control over image editing and viewing, and with a variety of useful tools which heretofore have been unavailable in PACS.
This brief summary has been provided so that the nature of the invention may be understood quickly. A more complete understanding of the invention can be obtained by reference to the following detailed description of the preferred embodiment thereof in connection with the attached drawings.